KEN WOOD, D.D.S. M.S. CHILDRENS DENTISTRY


Address: 2702 S Culberhouse St, Suite Q, Jonesboro, AR 72401-7132
Phone: 8709315437

KEN WOOD, D.D.S. M.S. CHILDRENS DENTISTRY (NPI# 1790909752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790909752
Entity Type Organization
Organization Name KEN WOOD, D.D.S. M.S. CHILDRENS DENTISTRY
Practice Address 2702 S Culberhouse St
Suite Q
Jonesboro
AR 72401-7132
Mailing Address Po Box 1369
Jonesboro
AR 72403-1369
Practice Telephone 8709315437
Practice Fax Number 8709319781
Mailing Telephone 8709315437
Mailing Fax Number 8709319781
Enumeration Date 2007-04-12
Last Update Date 2007-07-18
Authorized Official Name KENNETH I WOOD (DOCTOR)
Authorized Official Telephone 8709315437
Authorized Official Credential D.D.S., M.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
2738 AR Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
AR ARKANSAS BLUE CROSS BLUE 59239 01
AR UNITED CONCORDIA 828134 01

Office Location

Street Address 2702 S CULBERHOUSE ST
SUITE Q
City JONESBORO
State AR
Zip Code 72401-7132

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407453368 Mariah Kay Jackson Physical Therapy Assistant Creative Kids Therapy, Jonesboro, AR 72401 2020-10-05
1821606005 Kafayat Folake Iyanda Specialist/Technologist 2105 East Aggie Rd, Jonesboro, AR 72401 2020-07-14
1053936310 Josh Roberts Physical Therapist 1010 South Main St, Jonesboro, AR 72401 2020-06-12
1003449687 Amy Mary Elizabeth Daughhetee Nurse Practitioner 225 East Washington Ave, Jonesboro, AR 72401 2020-02-21
1871126698 Sarah Lowtharp Clinical Nurse Specialist 225 East Washington Ave., Jonesboro, AR 72401 2020-02-20
1891335519 Mallori Miller Case Manager/Care Coordinator 837 Willett Rd, Jonesboro, AR 72401 2020-01-10
1265073704 Michael Bruce Collie Registered Nurse 837 Williett Road, Jonesboro, AR 72401 2019-10-07
1285283432 Jonesboro Ambulatory Surgery Center, LLC Clinic/Center 1710 Mayfield Dr, Jonesboro, AR 72401 2019-09-10
1841843943 Destinee Katrina Cole Specialist/Technologist 2015 Aggie Rd, Jonesboro, AR 72401 2019-07-18
1699250472 Jessica Marie Mcnatt Occupational Therapist 907 County Road 753, Jonesboro, AR 72401 2018-09-27
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720242167 Summer Barker Tyson Dentist 620 Southwest Dr, Jonesboro, AR 72401-5859 2008-07-15
1447310883 Michael Douglas Oliver Jr. Dentist 809 Windover Rd, Jonesboro, AR 72401-6010 2006-12-08
1548360001 Ken I Wood Dentist 2702 Culberhouse, Southwest Village, Jonesboro, AR 72401 2006-09-25
1164411674 Dentistry for Children Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2005-10-18
1861937518 Axpm Jonesboro Pedo, Pllc Dentist 1150 E Matthews Ave, Ste 102, Jonesboro, AR 72401-4346 2017-01-04
1225402373 Homegrown Pediatric Dentistry and Orthodontics Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2015-11-30
1801181672 Clemmisa Louise Harris Dentist 809 Windover Rd, Jonesboro, AR 72401-6010 2011-06-09
1538453006 Tyson Dental Associates Pllc Dentist 620 Southwest Dr, Jonesboro, AR 72401-5859 2011-06-02
1689791519 Angel M Guardiola Dentist 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 2007-03-24
1902829161 Brad Warren Roehl Dentist 435 Arrowhead Blvd, Jonesboro, GA 30236-1219 2006-07-26
Find all providers in JONESBORO

Competitor

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City JONESBORO
Zip Code 72401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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